myocardial infarction Flashcards

1
Q

what part of actin myosin filament is sensitive to calcium concentration

A

troponin c

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2
Q

define myocardial infarction

A

specifically it is death of cardiac muscle due to lack of oxygen being supplied

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3
Q

what is used to diagnosed MI

A

troponin T and I which leak into blood when cardiac cell myocytes rupture during MI. T and I are unique to cardiac muscle

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4
Q

Why does an individual get chest pain upon MI, describe the pain

A

no somatic innervation of heart so a deep pain that can’t be localised, pain around neck chest and left arm,
metabolism is disrupted and adenosine is accumulating. a result of no oxygen

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5
Q

people with chest pain due to heart issue often confuse it with

A

indigestion

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6
Q

what is the advantage of coronary ateries being able to resist stenosis up until about 90 percent

A

resting blood flow through it can be maintained for a long time, enabling myocytes to be oxygenated

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7
Q

what is flow reserve

A

the ability for the conary ateries to dilate and increase blood flow when necessary due to increased demands

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8
Q

what is stable angina

A

flow reserve decreased due to stenosis, so when you exercise greater energy demand, not enough oxygen being delivered, adenosine buildup causing pain, if you rest demand goes down and flow reserve is enough. example of stable angina

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9
Q

name some of the characteristics of angina

A
Site and Radiation
–Diffuse, Anterior chest, Left arm, Neck
• Character
–Tight, pressure, weight, constriction, dull
• Triggers (angina)
–Exercise, cold, meals, psychological stress
• Relief (angina)
–Rest, GTN
• Duration
–<30 mins angina
–>30 mins infarction
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10
Q

why does someone expieriencing MI feel breathlessness and disorientated

A

occluded artery due to plaque rupture, no oxygen that part of the heart muscle dies or shuts down, or turns off what consumes the most energy e.g contraction, lack of oxygen to brain and other visceral organs causing increased breathing and brain not getting oxygen will cause disorientation

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11
Q

in right heart failure where is the oedma

A

ankle oedma

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12
Q

what does left heart failure result in

A

lung oeedma, thickening of liquid means co2 can still leave as it is soluble but harder for oxygen to enter, causing hypoxia

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13
Q

as heart failure increase what happens to frank starling mechanism

A

association between end diastolic pressure and cardiac output grows weaker and weaker

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14
Q

how does a thrombus from in coronary atery

A

rupture of atherosclerosis plaque, platelets adhesion to cholesterol and foam cells, starts clotting cascade traps blood in fibrogen web. blocks flow

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15
Q

what is used to treat people at risk of occluded arteries

A

aspirin anti platelet

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16
Q

what are the side effects of thrombolytic drugs

A

generalised lack of blood clotting risk of internal bleeding

17
Q

what are the advantages of mechanical re-perfusion vs pharmacological treatment of coronary arteries

A
• Faster reperfusion
• Higher % reperfusion
• Less stroke and
bleeds
• Lower mortality
18
Q

describe Balance between cardiac supply and

demand in healthy heart and abnormal one

A

in healthy heart supply and demand is always balanced, in an individual with CAD supply is reduced and demand is greater

19
Q

what drugs improve supply demand balance

A
“Anti-anginals”
–Beta-adrenoceptor blockers
–L-type calcium channel blockers
–Nitrates
–ATP-sensitive potassium channel
openers
–If channel blockers
20
Q

how do you stop a person who has had MI from suffering from it again, what areas do you target

A
•  cholesterol
•  BP
• ACE-I
• Aspirin+ADP
receptor
antagonist
• Betablockers
• Statins
Smoking
Diabetes
21
Q

distinguish between NSTEMI and STEMI

A

one has st elevtaion while the other has none, read up on the clinical implications for this and why it occurs

22
Q

name three classes of drugs used to combat MI

A

chlesterol lowering, anti platelet, clot busters

23
Q

state non modifiable risk for cardiovascular disease

A

Non-Modifiable
• Family history
• Age
• Sex

24
Q

state modifiable cardiovascular disease risk

A
  • Smoking
  • High Cholesterol
  • High Blood Pressure
  • Diabetes
  • Obesity/Diet/Exercise
  • XS Alcohol